Dental and Oral Health (Adults)

Dry Mouth

03/09/2010

Question:

I have developed a very very dry mouth. I am not thirsty at all. Also a little bump (looks like a pimple) on the side of the tongue. I clench my teeth and you can see the indentation of them on the tongue. My tongue is also cracked and painful from being so dry.

Answer:

There are many causes of dry mouth or xerostomia, and many may not be concordant with perception of thirst, or needing a drink of liquid.

The “little bump on the side of the tongue” may be an enlarged lingual papilla, or “crenations,” scalloping of the tongue tissue as a result of the tongue being in the line of occlusion of the teeth.

Now, the causes of dry mouth may be related to medications; a large number of meds have some form of effect on salivary flow, most associated with a discernable reduction in flow. Are you a mouth breather? That can be related to your complaint, as breathing through you mouth and not through your nose can dry out the oral mucosal tissues. Are you on any over-the-counter (OTC) medications for allergy or sinus/runny nose? Most of these types of meds can significantly dry out your mouth.

My advice is if this has been a frequent problem you should have it evaluated by either your primary care provider or dentist. My concern is that even though the salivary glands exhibit a decrease in functional activity with age, you still should have adequate flow and mucosal lubrication to function normally.

A “grocery list” of causes includes, medications, systemic disease like Sjogren’s disease, Lupus (SLE), Diabetes, Parkinson’s disease, aging and dehydration. I left out the later, based upon the fact that you stated you were not thirsty, and in most cases dehydration would illicit the thirst response. Infections may also be related to loss of salivary function as could certain neoplasm’s that are specific to the salivary glands. There are simple tests that can be performed to evaluate salivary function, most of which are as easy as spitting into a tube and measuring saliva production in a specific amount of time.

Salivary flow measurements will aid the clinician in determining if additional testing (imaging or biopsy or both) is required. Management of the problem may be palliative (chewing gum or sucking on sour candies) to more aggressive medications to stimulate salivary flow.

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